Transitions to work for persons with serious mental illness in northeastern Ontario, Canada: examining barriers to employment

This paper considers the importance of place in the conceptualization of transitions to work for persons with serious mental illness (SMI). A qualitative case study was conducted to explore the influence of place on access to employment for persons with SMI. In-depth interviews, focus groups, and demographic data collected from urban and rural residing individuals who experience SMI, mental health and vocational service providers, and decision makers across northeastern Ontario inform this paper. The results highlight the primary theme, stuck in the mud, which explains how people with SMI, service providers and decision makers are stuck regarding employment. Ultimately, their being stuck creates a variety of place-related tensions and a tendency to settle for less in the area of employment for persons with SMI. The condition of being stuck in the mud is expressed as a metaphor depicting the existing tensions between ideas which govern provincial employment policy for persons with SMI and the mainstream or dominant discourse governing local organizations, programs and practices in the case communities and supports the need to consider place in policy implementation.